Determinants of Utilization of Skilled Care During Delivery Among Women of Reproductive Age in Narok County, Kenya

Abstract

In Narok County where the present study was conducted; only 18% of children are born in clinical facilities. Narok county has among the worst Maternal and Child Health outcomes in Kenya including a high MMR of 434/100,000 births. Maternal health service coverage is poor: <30% of the population has access to services; 17% attend ANC; 17.6% of pregnant women have skilled assistance at delivery (KDHS 08/09). The study was guided by the following objective which were to: assess the extent to which social characteristics of women influence the utilization of skilled care during delivery among women of reproductive age, examine the extent to which cultural perceptions, determine the extent to which accessibility to health facility contributes to utilization of skilled care during delivery and assess the extent to which the perception on the quality of care at health facility contributes to women delivering in health facilities. The study was guided by the following hypotheses: There is a significant relationship in the social characteristics of women in Loita and utilization of skilled delivery, cultural perceptions of women of reproductive age in Loita Division contribute to utilization of skilled delivery, accessibility to health facility contributes to women utilizing skilled care during delivery in Loita Division and perception on the quality of care at health facilities contribute to women delivering in health facilities. The study used questionnaires and interview data of 40 married women aged 15-49 years to collect data for the study in Loita Division Narok County. The mean age of the sample women was 26 years. The results showed that the uptake of antenatal and delivery services from a skilled birth attendant is unacceptably low in rural Loita Division, which is a challenge for meeting the millennium development goals. The study recommends programmes for improving economic status as a key to improving newborn care practices. As the vast majority of the deliveries are still assisted by traditional birth attendants. Increasing women’s access to a skilled birth attendant and boosting the spirit of the TBA to increase their efficiency is also recommended. Future research on before and after birth health check for both mother and child should be done in focus of identifying other determinants of skilled care practices and child survival. Qualitative studies to understand the cultural perspectives of skilled care practices are also recommended.